People with diabetes have a higher risk of developing cardiovascular disease. In fact, 65 percent of people with diabetes die from some form of heart disease or stroke, according to the American Heart Association.

"We really try to drive that point home for people with diabetes," said Lorie Roffelsen, a registered dietitian at Washington Hospital. "Keeping your blood glucose under control can help to reduce your risk of heart disease and stroke as well as eating a heart healthy diet."

She will present "Top Foods for Heart Health," on Thursday, October 4, from 7 to 8 p.m. It will be held at the Conrad E. Anderson, M.D. Auditorium, 2500 Mowry Avenue (Washington West), in Fremont. The seminar is part of Washington Hospital's free monthly Diabetes Matters education series.

Diabetes occurs when the body does not produce enough insulin or is not able to use it properly. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy. When this process doesn't work properly, glucose (sugar) levels in the blood can get too high, which damages the blood vessels.

This excess glucose can attach to proteins in the blood vessels and alter their normal structure and function. The blood vessels can become thicker and less elastic, making it harder for blood to pass through them.

In addition, according to the American Heart Association, people with diabetes often have the following conditions that compound their risk for developing cardiovascular disease:* High cholesterol causes plaque to build up in the walls of the arteries, causing a process called atherosclerosis. The arteries become narrowed and blood flow to the heart muscle is slowed down or blocked.* High blood pressure (hypertension) is dangerous because it makes the heart work harder than normal to circulate blood through the blood vessels and contributes to atherosclerosis. * Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.

Less Fat, More Fiber

Roffelsen will offer tips for eating a heart healthy diet that can help to reduce these risk factors. She will focus on some of the foods to avoid as well as those that should be eaten more often because they may be able to protect against heart disease.

She said it's important to reduce the amount of salt and saturated fat in your diet. Saturated fats are found in a number of common foods, including high-fat cheeses, fatty cuts of meat, whole milk and cream, butter, ice cream and ice cream products, and palm and coconut oils.

Instead, stick to low-fat dairy products like 1 percent or fat-free milk and low-fat cheeses. Buy leaner cuts of meat and eat more poultry and fish, she recommended. Use healthier types of oil like olive or canola oil.

"Grill or bake your fish instead of frying it in oil," Roffelsen said. "Substitute high-fat lunch meats like bologna and pastrami with lean turkey. And avoid processed foods, which often contain high amounts of salt and fat."

She said it's a good idea to eat fish at least once a week, particularly the types that contain omega 3 fatty acids, which have been shown to reduce the risk of heart disease. Omega 3 is found in fish like salmon, tuna, mackerel and sardine as well as nuts and seeds like walnuts and flax seed.

"Some people take fish oil supplements, but you should talk to your doctor first to see if that is a good idea for you," Roffelsen added.

Fiber should also be included in the diet. She will talk about the importance of eating plenty of fiber, which is found in fruits and vegetables and whole grains.

"Fiber works like a sponge in the gut to bind some of the cholesterol in the food you eat," she explained. "Good sources of fiber are citrus fruit, oatmeal, barley, apples, and pears."

Most experts agree that eating sterol and stanol-containing foods is another way to lower your cholesterol, which helps reduce the risk of heart disease, according to Roffelsen.

Plant sterols and stanols occur naturally in small amounts in many grains, vegetables, fruits, legumes, nuts, and seeds and are now being added to a number of foods like margarine spreads, orange juice, and cereals.

To learn about other diabetes programs at Washington Hospital, visit www.whhs.com/diabetes.